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J. Am. Acad. Dermatol. · Feb 2015
ReviewMycoplasma pneumoniae-induced rash and mucositis as a syndrome distinct from Stevens-Johnson syndrome and erythema multiforme: a systematic review.
- Theresa N Canavan, Erin F Mathes, Ilona Frieden, and Kanade Shinkai.
- Department of Dermatology, University of Alabama, Birmingham, Alabama.
- J. Am. Acad. Dermatol. 2015 Feb 1;72(2):239-45.
BackgroundMycoplasma pneumoniae infection is associated with extrapulmonary complications, including mucocutaneous eruptions. These eruptions, which have been termed either "Stevens-Johnson syndrome" or "erythema multiforme" in the literature, may differ from drug-induced Stevens-Johnson syndrome or viral-associated erythema multiforme.ObjectiveWe sought to review the literature characterizing morphology and disease course of M pneumoniae-associated mucocutaneous disease.MethodsA comprehensive literature search identified 95 articles with 202 cases.ResultsPatients were often young (mean age: 11.9 years) and male (66%). Cutaneous involvement ranged from absent (34%), to sparse (47%), to moderate (19%). Oral, ocular, and urogenital mucositis was reported in 94%, 82%, and 63% of cases, respectively. Treatments included antibiotics (80%), systemic corticosteroids (35%), supportive care alone (8%), and/or intravenous immunoglobulin (8%). Complications included mucosal damage (10%), cutaneous scarring (5.6%), recurrence (8%), and mortality (3%).LimitationsMild cases may not have been published; thus this review may have a bias toward more severe disease.ConclusionM pneumoniae-associated mucocutaneous disease has prominent mucositis and sparse cutaneous involvement, although cutaneous involvement varies. Because of the distinct morphology, mild disease course, and potentially important clinical implications regarding treatment, we propose a revision of the nomenclature system and suggest the term "Mycoplasma-induced rash and mucositis" for these cases.Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
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